DSM-5 publication date May 22: American Psychiatric Association to release DSM-5 between May 18-22, San Francisco

After 14 years and with a staggering $25 million thrown at it, the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will be launched during the American Psychiatric Association’s (APA) Annual Meeting in San Francisco, May 18-22, 2013.

Further revisions and refinements to the criteria sets and disorder descriptions, following closure of the third and final stakeholder review and comment period (June 15, 2012) and the finalizing of texts in December and January, are embargoed and won’t be evident until the manual is released, next month.

Draft proposals, as they had stood on the DSM-5 Development site for the third stakeholder review, were removed from the APA’s website last November. Additional pages archiving draft proposals for DSM-5 Development internal use which remained publicly accessible were put behind a webmaster log in, around mid March.

(No drafts of the expanded texts that accompany the disorder sections and categories have been available for public scrutiny at any stage in the drafting process.)

The official publication date for DSM-5 is May 22 for the U.S. (May 31 for UK). The manual is 1000 pages and costs nearly $200 for the hardcover edition. An electronic version of the DSM-5 is understood to be in development for later this year.

According to this December 1 interview with Task Force Chair, David J Kupfer, MD, for the Washingtonian,

…While it will likely be some time before we can expect a DSM-6, it may only be a few years until a DSM-5.1 or -5.2, thanks to the expected digital version of the manual. “We don’t wait to wait another 19 to 20 years to have a new revision of the whole volume,” says Kupfer. “But if there is some unexpected consequence, which we can’t anticipate, we have an opportunity to fix something two to three years from now.”

Also at that URL – fact sheets, articles and videos for selected categories, which are being added to every few weeks (including justifications for some of the more controversial changes and new inclusions), and the following documents relating to the overall development process:

Temper tantrum, or ‘disruptive mood dysregulation disorder’? A look at the new psychiatric guidelines that are pitting doctors against doctors

Anne Kingston | Tuesday, March 19, 2013

…Under the new “somatic symptom disorder” (SSD), for instance, people who express any anxiety about physical symptoms could also be saddled with a mental illness diagnosis, which could thwart their attempts to have their physical issues taken seriously. To meet the definition one only needs to report a single bodily symptom that’s distressing and/or disruptive to daily life and have just one of the following three reactions for at least six months: “ ‘disproportionate’ thoughts about the seriousness of their symptom(s); a high level of anxiety about their health; devoting excessive time and energy to symptoms or health concerns.”

J. E. Dimsdale, University of California, San Diego, DSM Task force, Somatic Symptoms Work Group

Die Psychiatrie 2013; 10: 30–32

Summary

Following a brief historic discourse, problems with the current use and concepts the of somatoform disorders are described. The rationale for substituting the term “somatoform” with “somatic symptom” in DSM5 is explained and the new classification criteria for the group of “somatic symptom related disorders” are described, which include severity ratings.

A special aspect is that “Illness anxiety disorder” is introduced as a new diagnostic entity in DSM-5.

A number of new documents and short videos on ‘Somatic Symptom Disorder’ have been published on the APA’s new webpages, plus an article in Psychiatric News, published on March 1.

These are followed by recent, mainstream media coverage of concerns for all illness groups for the implications of misdiagnosis with ‘Somatic Symptom Disorder’ or for an additional diagnosis of ‘Somatic Symptom Disorder.’

“…But Joel Dimsdale, M.D., chair of the Somatic Symptom and Related Disorders Work Group, emphasized that the most important change overall in this set of disorders is removal of the centrality of medically unexplained symptoms. “That was a defining characteristic of these disorders in DSM-IV, but we believe it was unhelpful and promoted a mind-body dualism that is hard to justify,” he told Psychiatric News.

So, for instance, the diagnosis of somatization disorder in DSM-IV was based on a long and complex symptom count of medically unexplained symptoms. DSM-5 criteria eliminate that requirement and recognize that individuals who meet criteria for somatic symptom disorder—the new designation, marked by disproportionate thoughts, feelings, and behaviors related to somatic symptoms—may or may not have a medically diagnosed condition.

Hypochondriasis has been eliminated; most individuals who would previously have been diagnosed with hypochondriasis have significant somatic symptoms in addition to their high health anxiety and should receive a DSM-5 diagnosis of somatic symptom disorder. Those with high health anxiety without somatic symptoms should receive a diagnosis of illness anxiety disorder…

“Members of the Overlapping Conditions Alliance (OCA) produced a white paper, Chronic Pain in Women: Neglect, Dismissal and Discrimination, to promote awareness and research of neglected and poorly understood chronic pain conditions that affect millions of American women. This report, which can be viewed and downloaded below, includes detailed policy recommendations to further these goals.” (Report 2010 and Report 2011)

ARLINGTON, Va. (Feb. 28, 2013) – The American Psychiatric Association’s 166th Annual Meeting, the world’s largest psychiatric meeting, will run Saturday, May 18 to Wednesday, May 22, 2013 in San Francisco at the Moscone Convention Center. The much anticipated DSM-5, the latest revision of the Diagnostic and Statistical Manual of Mental Disorders, will be released at the meeting…

The Centers for Medicare and Medicaid Services (CMS) will maintain their commitment to the current ICD-10-CM/PCS compliance date of October 1, 2014, according to a letter sent to AHIMA President Kathleen A. Frawley.

The letter was sent in response to AHIMA’s call for CMS to stand firm on its ICD-10 implementation date after more than 80 physician groups represented by the American Medical Association called on CMS in January to delay or abandon the ICD-10 conversion…

Critics worry that patients will be misdiagnosed as mentally ill and won’t get treatment, affecting mostly those with chronic and difficult to diagnose neurological disorders and multi-system diseases like ME/CFS, ones that are poorly understood and can take years to get medical answers.

“A lot of people will be written off as crocks — it’s just in their head,” said Dr. Allen Frances, who was chair of the task force that created the DSM-4 and professor emeritus of psychiatry at Duke University. “They won’t get the medical work-up they need.”

…But [SSD work group chair] Dimsdale defends the updated DSM…”If it doesn’t work, we’ll fix it in the DSM-5.1 or DSM-6.”

…In a recent article, Postmedia’s Sharon Kirkey quotes a statement from the American Psychiatric Association, which will publish a new edition of the DSM in May: “Some patients with illnesses like heart disease or cancer will indeed experience thoughts, feelings or behaviours related to their illness that will be extreme or overwhelming.” These individuals “may qualify for an SSD diagnosis…”

These days, I get a lot of grief about grief. I am part of the work group that changed some of the ways that grief and clinical depression are described and differentiated in the new Diagnostic and Statistical Manual of Mental Disorders, typically referred to as DSM-5. That has led to a lot of conversations with colleagues who are upset about bereavement…

Author Affiliations: University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania (Dr Kupfer); and American Psychiatric Institute for Research and Education, Division of Research, American Psychiatric Association, Arlington, Virginia (Drs Kuhl and Regier).

A controversial new mental diagnosis could label thousands of people with legitimate medical illnesses as psychiatrically sick and in need of treatment if they worry “excessively” about their symptoms, observers says.

The newest version of psychiatry’s official catalogue of mental disorders, due to be published in May, will contain a newly expanded definition of “somatic symptom disorder,” or SSD.

Under the previous edition of the Diagnostic and Statistical Manual of Mental Disorders — an influential guidebook used by doctors around the globe — somatoform disorders applied to people with medically unexplained health complaints. The diagnosis required that physical, bodily symptoms couldn’t be traced to any identifiable, underlying medical cause.

In the fifth and latest edition of the manual, known as DSM-5, that proviso has been removed.

The new diagnosis doesn’t distinguish between “medically unexplained” symptoms or symptoms related to an actual underlying medical problem…

The first in a series of three commentaries by Allen Frances, MD, on the Somatic Symptoms Disorder issue has received over 25,000 page views on Psychology Today, alone. It was also published at Huffington Post and on “Education Update,” and now also at Psychiatric Times.

There are already about a dozen different DSM 5 petitions and boycotts out there. This is completely understandable – there is lots in DSM 5 to be angry at or frightened about.

Unfortunately, though, this is not a case of more the merrier. Fragmentation into a number of small protests will greatly reduce their aggregate impact…

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David J. Kupfer, MD, chairs the DSM-5 Task Force. On February 8, Dr Kupfer published in defence of the SSD construct on Huffington Post. Part Three in the Allen Frances and Suzy Chapman series of commentaries on the SSD criteria was published earlier, last week, Saving Normal on Psychology Today:

While the goal of the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is clear, accurate criteria for diagnosing mental disorders, the motivation behind the book’s revision was the improvement of diagnosis and clinical care. Somatoform disorders are one area where definitive progress was made.

Somatoform disorders are characterized by symptoms suggesting physical illness or injury, but which may not be fully explained by a general medical condition, another mental disorder, or by medication or substance side effects. The symptoms are either very distressing or result in significant disruption of an individual’s ability to function in daily life. People suffering from somatoform disorders are often initially seen in general medical settings as opposed to psychiatric settings…

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This new post from Christopher Lane on the DSM-5 ‘Somatic Symptom Disorder’ controversy has been designated a Psychology Today “Essential Read” editor pick:

Side EffectsFrom quirky to serious, trends in psychology and psychiatry
by Christopher Lane, Ph.D.

When DSM-5 is published three months from now, in the middle of May, it will contain at least one major scientific gaffe. The Trustees of the American Psychiatric Association voted to include a definition of Somatic Symptom Disorder (SSD) so broad and over-inclusive that it is certain to include medical patients with an outsized concern about their health, as well as those who are merely vigilant in trying to maintain it…

A two day international conference following the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will take place at the Institute of Psychiatry on the 4th and 5th of June 2013.

Mental health practitioners and researchers around the world anticipate the DSM-5 that is due to published by the American Psychiatric Association within the first few months of 2013.

Discussions about the DSM-5 have stretched well beyond the world of academic psychiatry having become a matter of intense public interest and media coverage.

The aim of this conference is to have a rigorous and comprehensive discussion of the clinical, research, and public health implications of the DSM-5. The perspective is international and speakers will include top scientists, key policy makers, patient representatives, and front-line clinicians.

Speakers include:

Professor David Kupfer, Head of DSM-5 Planning Committee and Professor at the University of Pittsburgh

Professor William Carpenter, DSM-5 Task Force Member and Professor at the University of Maryland

Professor David Clark, Professor of Experimental Psychology, University of Oxford

Dr Clare Gerada, General Practitioner and Chair of the Council of the Royal College of General Practitioners

Professor Catherine Lord, Director of the Center for Autism and the Developing Brain and Professor at the University of Michigan

Professor Vikram Patel, Professor of International Mental Health, London School of Hygiene and Tropical Medicine

Professor Nikolas Rose, Head of the Department of Social Science, Health and Medicine, Kings College London

Sir Michael Rutter, First Professor of child psychiatry in the UK and Professor of Developmental Psychopathology at Kings College London

Professor Norman Sartorius, Former director of the World Health Organization’s Division of Mental Health, and a former president of the World Psychiatric Association